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Home My WebLink About1000-41.-1-34 TOWN OF SOUTHOLD Rental Permit r Permit No. 0436 Owner Irene Garner Occupied as Single Family Dwelling Located at 760 (102) Washington Ave Greenport 41-1-34 Village Maximum Permitted Occupancy 5 Is in compliance with all of the provisions of the code of the Town of Southold, the laws and sanitary and housing regulations of the County of Suffolk and by the laws adopted by the New York State Fire Prevention and Building Code Council. Expiration is two (2) years from date of issue. The operator is responsible for arranging for the bi-annual inspection. 5/10/2021 Code E o e e t Official This Notice must be posted by the main entrance at all times nY � nkZ" f 0 ZurN p Town Hall Annex . Telephone(631)765-1802 54375 Main Road ' Fax(631)765-9502 P.O.Sox 1179 n1 sC Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD OCT - 5 2020 RENTAL PERM IT,APPLICATION ' Rental Permit Fee $200 (Application must be renewed every two years) Section A. Property Information: Rental Property Address:- _ 3 Tax Map Number: 1000 SECTION -BLOCK -LOT 3 7 . 5 Y'LI C_ar -)L ` SECTION B. OWNER INFORMATION: Property Owner Name: �� Property Owner Legal Address: I Property Owner Mailing Address: G?.a4Q t (� Q5� `� LS L Telephone Number(s): Daytime 631—VS Evening.. Emergenc Property Owner Email Address: - - � n � �a a Kow kep_ -. ,Teo t� Page 1&5 Pc Cee__ s 51 Town Hall Annex Telephone(631)765-1802 54375 Main Road n Fax(631)765-9502 P.O.Box 1179 ! O Southold,NY 11971-0959 '69, BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. _ Authorized Agent Information: t Name of Authorized Agent of dwelling unit, if any: V'4 r_r�o Gta�er' Address of Authorized Agent (no P.O. Boxes): e. H .Mailing Address of Authorized Agent: - �112P, Telephone Number(s): Da Dime v ning Emergency Email Address:,'.. So m4 o W. Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: kNag Address of Authorized Agent (no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number(s): Daytime Evening Emergency Email Address:- SECTION E. SITE MANAGER INFORMATION:.(required for rental properties containing 8 or more rental units) Name of Managing Agent of dwelling unit, if any:. Address of Managing Agent (no P.O. Boxes): Page 2 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: i n Telephone Number(s): Daytime Evening Emergency Email Address: , SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwe.Iling Units on property: �` �l der'/ rekk For each Rental Dwelling Unit set forth the Rental Dwelling Unit identifier(for example, Unit 1, Unit 2, Unit 3 or Apt A, B, Q the use of each room in the Rental Dwelling Unit (for example, Kitchen, Bedroom 1, Bedroom 2, Living Room) and the dimensions of each room. For properties with multiple Rental Dwelling Units use "Rental Permit Application Addendum." .F Rental Dwelling Unit Identifier: Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: Use and Dimensions of each ro .m in Rental Dwelling nit: �! C G Page 3 of 5 Town Hall Annex J [ Telephone(631)765-1802 54375 Main Road r Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 "BUILDING DEPARTMENT TOWN OF SOUTHOLD SECTION G. INSPECTION: Pursuant to the Town Code of the Town of Southold Chapter 207 (Rental Properties),a safety inspection by Code Enforcement Official is required. If the owner chooses not to have said inspection performed by the Town, a certification from a licensed architect, a licensed professional engineer or a home inspector who has a valid New York State Uniform Fire Prevention Building Code Certification is required stating that the property which is-the subject of the rental permit application is in compliance with all of the provisions of the code of the Town of Southold,the laws and sanitary and housing regulations of the County of Suffolk and by the laws adopted by the New York State Fire Prevention and Building Code Council'. 0la1 am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold ❑ I am submitting a completed Town of Southold certification form from a licensed architect or a licensed professional engineer. SECTION H. DECLARATION: Signature must be notarized and MIDST be the owner of the dwelling unit. STATE OF NEW YORK) COUNTY OF SUFFOLK) &, � � , certify under penalty of perjury,the following: 1. 1 am the owner of the property identified in "Section A" of this application. 2. The property owner's legal address set forth in "Section B" of this application is my legal address and I understand the Town will use the address for service pursuant to all Page 4 of 5 i Soil Town Hall Annex Telephone(631)765-1802 54375 Main Road h4 Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 .BUILDING DEPARTMENT TOWN OF SOUTHOLID applicable laws and rules. I further acknowledge that I will notify the Town of Southold Building Department of any changes of address within five (5) days of any changes thereto. 3. 1 have read and received a copy of Chapter 207 of the Code of the Town of Southold and agreed to abide by the same. 4. 1 will notify the Town within five (5) business days as to any change to the information regarding Authorized Agent, Managing Agent, or Site Manager. Property Owner's Name:. Property Owner's Signature: i Sworn to before me thisc day of 202 Official Notary Public Signature and Original Notary Stamp CAR&MJA BURKE R1pt�ryPtt�C.St�eaffYurk . Flo.30Z528265 Qualified in Suffolk County Cow..nts,.r l.�.CEs Nori.,ert 3o.7a1g7 Page 5 of 5 OFSOUTyolo (o0 UJAJdA� # # TOWN OIF SO HOLD- BUILDING DEPT." ��Y�OUNIV,� 765-1802 (. INSPECTION q FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATIOWCAULKING [ ] FRAMING /STRAPPING [ ] FINAL Atv�l [ ] FIREPLACE & CHIMNEY ['v] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: \ 1 - v QvA vg- DATE 3 37-0 - INSPECTOR Mr. David Garner ! 3_r 201 Sassafras Ln - ~ ` Milton,DE 19968 UtA ro P �u #5�q 77% t f j _ l ' ! / s - YOVic; �JU . C4'V CID kk R C� e- ij p U)IVP t )1 � v o"o A ,71 t n: - �A ` . TOWN OF SOUTHOLD PROPERTY �cARD OWNER STREET '' ) VILLAGE DIST' SUB. LOT t r�r r Phi � wn'sva 5AI VLA( � FORMER OWNER N E AC�� J S W TYPE OF BUILDING f 1(7 V I C L rKza r \ RES. /D SEAS. VL. FARM 'Comm'. CB'. MICS. i V41u r LAND IlNR TOTAL DATE -REMARKS Cl? 4e12,7101_L)211 o C:f = - r re�a/YJs VZ 420o AGE -BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Acre Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD r - Meadowland DEPTH ,, House pot BULKHEAD � Total DOCK • . ' ' �. - ■■■!i■■■■FINE■■■■■■■■■IMMINE NEI Mm Endo= Rome MEN ■N■ OMEN ■■■■■■E ■/!■■!■ RMOIRS01 IMMIMMEME GE FA MR 020,12 W UM AM 0 RON PRIPH mm MEN mmENNE IN ■■■■■■■■■f(i■■■■■■■ !■N 'Inferior Finish . • Heat. bf Rooms Ist Floor Bp °. a �� ° ' 'e a °.• °.a • •• r : -- • . • ner Drivewcy 0 F04cam, Town of Southold 5/8/2021 ao� �G53095 Main Rd h Southold,New York 11971 o -170 PRE EXISTING CERTIFICATE OF OCCUPANCY No: 42018 Date: 5/1/2021 THIS CERTIFIES that the structure(s)located at: 760(102)Washington Ave,Greenport SCTM#: 473889 Sec/Block/Lot: 41.-1-34 Subdivision: Filed Map No. Lot No. conforms substantially to the requirements for a built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 42018 dated 5/1/2021 was issued and conforms to all the requriements of the applicable provisions of the law. The occupancy for which this certificate is issued is: wood frame one family dwelling;with rear porch and accessory wood frame garage_* The certificate is issued to Garner,Irene (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. Au 7 d Signature BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 760(102)Washington Ave,Greenport SUFF.CO.TAX MAP NO.: 41.-1-34 SUBDIVISION: NAME OF OWNER(S): Garner,Irene OCCUPANCY: ADMITTED BY: SOURCE OF REQUEST: Garner,Irene DATE: 5/1/2021 DWELLING: #STORIES: 1 #EXITS: 2 FOUNDATION: cement block CELLAR: full CRAWL SPACE: BATHROOM(S): 1 TOILET ROOM(S): 1 UTILITY ROOM(S): PORCH TYPE: rear covered DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HOTWATER: yes TYPE HEATER: oil AIR-CONDITIONING: TYPE HEAT: OR WARM AIR: HOT WATER: baseboard #BEDROOMS: 4 #KITCHENS: 1 BASEMENT TYPE: unfinished OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: wood frame STORAGE,TYPE OF CONST: SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: VIOLATIONS: REMARKS: INSPECTED BY: JOHNJ DATE OF INSPECTION: 3/3/2021 TAM START: 1:58pm END: 2:25pm b �o�Og�FFOLK�'pGy Town of Southold 5/1/2021 ' P.O.Box 1179 o ` r 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 42006 Date: 5/1/2021 THIS CERTIFIES that the building HVAC Location of Property: 760(102)Washington Ave.,Greenport SCTM#: 473889 Sec/Block/Lot: 41.-1-34 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 3/16/2021 pursuant to which Building Permit No. 46039 dated 4/6/2021 was issued,and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: "as built'HVAC system and electrical survey as applied for. The certificate is issued to Gamer,Irene of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 46039 4/16/2021 PLUMBERS CERTIFICATION DATED Authorized Signature